Weighty Issues

By Jessica Seaton, D.C.

 

 

Headline in the Los Angeles Times, December 14, 2001:

 

Surgeon General Takes Stern Stance on Obesity

Health: American 'epidemic' is compared to smoking in its health risks. Lifestyle changes are strongly urged.

 

WASHINGTON -- The nation's epidemic of obesity is almost as menacing to health as smoking, the U.S. surgeon general said Thursday as he called on Americans to eat less and exercise more.

 

Deaths related to obesity have reached 300,000 a year, said Dr. David Satcher, compared with 400,000 deaths annually from illnesses associated with smoking. Heart attacks, diabetes, strokes and various forms of cancer have all been linked to obesity, Satcher said…

 

All Americans Asked to Lose 10 Pounds

 

To fight the epidemic, all Americans should lose 10 pounds as a patriotic gesture, said Health and Human Services Secretary Tommy G. Thompson.

 

The current guidelines used to determine who is normal weight, overweight, or obese involve calculating one’s Body Mass Index (BMI). The BMI is one’s weight in kilograms divided by one’s height in meters. For those who don’t have these metric figures available, one can also calculate the BMI by multiplying one’s weight in pounds by 703, then dividing that figure by one’s height in inches, and then dividing that figure once again by one’s height in inches.

 

Weight (lbs)       

100                110                120                130                140                150                160                170                180                190                200                210                220                230                240                250                260                270                280                290                300

Height

5', 0"       19.5                21.5                23.4                25.4                27.3                29.3                31.2                33.2                35.1                37.1                39.1

5', 1"       18.9                20.8                22.7                24.6                26.4                28.3                30.2                32.1                34                35.9                37.8                39.7

5', 2"       18.3                20.1                21.9                23.8                25.6                27.4                29.3                31.1                32.9                34.7                36.6                38.4                40.2

5', 3"       <18                19.5                21.3                23                24.8                26.6                28.3                30.1                31.9                33.7                35.4                37.2                39

5', 4"       <18                18.9                20.6                22.3                24                25.7                27.5                29.2                30.9                32.6                34.3                36                37.8                39.5

5', 5"       <18                18.3                20                21.6                23.3                25                26.6                28.3                30                31.6                33.3                24.9                36.6                38.3                39.9

5', 6"       <18                <18                19.4                21                22.6                24.2                25.8                27.4                29                30.7                32.3                33.9                35.5                37.1                38.7                40.3

5', 7"       <18                         18.8                20.4                21.9                23.5                25.1                26.6                28.2                29.8                31.3                32.9                34.5                36                37.6                39.2

5', 8"       <18                                         19.8                21.3                22.8                24.3                25.8                27.4                28.9                30.4                31.9                33.4                35                36.5                38                39.5

5', 9"       <18                                         19.2                20.7                22.1                23.6                25.1                26.6                28.1                29.5                31                32.5                34                35.4                36.9                38.4                39.9

5', 10"    <18                                         18.7                20.1                21.5                23                24.4                25.8                27.3                28.7                30.1                31.6                33                34.4                35.9                37.3                38.7                40.2

5', 11"    <18                                                         19.5                20.9                22.3                23.7                25.1                26.5                27.9                29.3                30.7                32.1                33.5                34.9                36.3                37.7                39

6', 0"       <18                                                         19                20.3                21.7                23.1                24.4                25.8                27.1                28.5                29.8                31.2                32.5                33.9                35.3                36.6                38                39.3

6', 1"       <18                                                         18.5                19.8                21.1                22.4                23.7                25.1                26.4                27.7                29                30.3                31.7                33                34.3                35.6                36.9                38.3                39.6

6', 2"       <18                                                                         19.3                20.5                21.8                23.1                24.4                25.7                27                28.2                29.5                30.8                32.1                33.4                34.7                35.9                37.2                38.5

6', 3"       <18                                                                         18.7                20                21.2                22.5                23.7                25                26.2                27.5                28.7                30                31.2                32.5                33.7                35                36.2                37.5

6', 4"       <18                                                                                         19.5                20.7                21.9                23.1                24.3                25.6                26.8                28                29.2                30.4                31.6                32.9                34.1                35.3                36.5

 

Note: Gray numbers are considered to be overweight. Numbers to the left of the gray numbers are normal weight, to the right are obese.

 

Doctor’s generally advise their patients to maintain a BMI of between 18.5 and 24.9. A BMI between 25 and 29.9 is considered overweight and above 30 is considered obese.

 

A study published in the July 2001 issue of Archives of Internal Medicine suggested that for both men and women the risk of developing diabetes, gallstones, hypertension, heart disease, and stroke increased proportionately to the amount they are overweight. The figures break down as follows:

BMI above 35: approximately 20 times more likely to develop the above-mentioned conditions than those in the 18.5 – 24.9 range.

BMI in the overweight range: three times more likely to develop diabetes within a ten year period, and twice as likely to develop gallstones. The risk of developing hypertension, high cholesterol, and heart disease were also elevated.

A surprising finding was that even those in the high-normal range (22.0 – 24.9) were twice as likely to develop diabetes, and were more likely than those with a BMI of less than 22 to develop any of the other above-mentioned conditions.

 

A Word of Caution

The BMI figure is not valid for extremely muscular individuals who have low body fat, such as body builders. People with body builder physiques are generally not swimming, because that kind of muscle mass would adversely affect buoyancy. However, there may be the exceptional individual out there.

 

Moderate Weight Loss May Help with Sleep-Disordered Breathing (SDB)

 

Sleep-disordered breathing is sometimes also known as sleep apnea. It is recognized by abnormally shallow or slow breathing, or a temporary absence of breathing during sleep. It may be associated with cardiovascular disease, high blood pressure, or even death. A study published in December 2000 in the Journal of the American Medical Association suggested that a ten percent increase in weight over a four year period of time resulted in a six-fold increase in the risk of developing moderate to severe SDB. Weight loss was associated with a decrease in severity or disappearance of the condition.

 

High-Protein Diets Do Not Promote Long-term  Weight Loss

 

The October 2001 issue of Circulation published a statement by the American Heart Association that confirmed that no evidence exists that high-protein, low carbohydrate diets promote long-term weight loss. Among the popular diets examined were the Atkins Diet and the Zone Diet. High protein diets promote short term weight loss. As the dieter initially cuts carbohydrates from his or her diet, a lot of water is lost. During the next phase, the body begins to break down fat, which suppresses the appetite. In addition, most of these diets are also restricting portions (therefore restricting caloric intake). Diets which are low in carbohydrates tend to be deficient in several important nutrients, such as vitamins and fiber. At the same time they are high in saturated fats, since most Americans get the bulk of their protein from animal sources. This combination puts the dieter at an increased risk for heart disease. However, once a normal diet is resumed, these people tend to return to their pre-diet weights.

 

The Secret to Weight Loss

 

The secret to weight loss is to burn more calories than are consumed. To maintain one’s weight, one needs to consume as many calories as one burns. To gain weight, one needs to consume more calories than are burned.

 

Rule of thumb: if your clothes are too tight you either need to eat less, or exercise more, or ideally do both.

 

As you cut down on how much you eat, what you eat becomes even more important. A diet rich in whole grains, fruits, and vegetables, with moderate amounts of meat, and small amounts of monounsaturated or polyunsaturated fats, is going to give you a lot more value than small amounts of junk food. If you combine this healthy diet with swimming four to five times per week, you should be able to reach your optimal weight more quickly.

 

Jessica Seaton, D.C., is a chiropractic orthopedist in private practice in West Los Angeles. She swims with West Hollywood Aquatics and is the chairperson of the SPMA Fitness committee and the USMS Sports Medicine Committee. She can be reached at (310) 470-0282 or at Jseaton@aol.com.